Repeat Coronary Angiography in Patients Aged over 50 Years with Previously Normal/Non-Obstructive Coronary Angiogram-Insights from a Retrospective Study
(1) : A significant proportion of patients undergoing coronary angiography (CAG) have normal (NCA) or non-obstructive coronary artery disease (NOCAD). This study retrospectively tested the incidence of re-catheterization, and long-term outcomes of this population in patients aged over 50 years. (2)...
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| Veröffentlicht in: | Journal of clinical medicine 2024-02, Vol.13 (3), p.870 |
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| creator | Roguin, Ariel Kobo, Ofer Meisel, Simha-Ron Darawsha, Ziad Odeh, Mahmood Frimerman, Aharon Amsalem, Naama Abu Fanne, Rami |
| description | (1)
: A significant proportion of patients undergoing coronary angiography (CAG) have normal (NCA) or non-obstructive coronary artery disease (NOCAD). This study retrospectively tested the incidence of re-catheterization, and long-term outcomes of this population in patients aged over 50 years. (2)
: We identified all patients above 50 years of age with NOCAD who underwent their first CAG at our center between January 2008 and December 2019. Patients were evaluated for their baseline characteristics, risk factors profile, and indication for CAG. Patients undergoing repeat CAG after the index procedure were assessed for the above, including the primary preventive pharmacotherapy prescribed. (3)
: A total of 1939 patients were reported to have NOCAD. Of these, 1756 (90%) patients (62% males, median age 66 (56-75) years) had no repeat angiography (group 1). Repeat angiography was performed in 10%: 136 (7%) proved futile (median time for repeat angiography 5 (3-8) years) (group 3), and 47 (3%) ended with angioplasty (median time for repeat angiography 4 (3-6) years) (group 2). Male gender, BMI above 30 (23% vs. 13%), hypertension (68% vs. 57%), diabetes (28% vs. 17%) and smoking (36% vs. 19%) were significantly higher in the interventional group. Regression analysis showed both paroxysmal atrial fibrillation and hyperlipidemia were significantly associated with repeat CAG. The indication for the first CAG was mainly symptoms related. In the interventional repeat angiography (
= 47) the incidence of troponin positive cases increased from 8.2% before intervention to 57.5%, 50% being ST elevation cases. The symptoms-related cases went from 36.7% to 18.4%. Intriguingly, 85% of the interventional group were not prescribed statin and/or aspirin on a regular basis, and/or did not adhere to treatment. (4)
: NOCAD is a frequent occurrence. The threshold for repeat angiography must be higher, better reserved to troponin positive cases. Moreover, patients must be handled according to their risk profile, not being mistakenly reassured by a snapshot benign coronary angiography. |
| doi_str_mv | 10.3390/jcm13030870 |
| format | Article |
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: A significant proportion of patients undergoing coronary angiography (CAG) have normal (NCA) or non-obstructive coronary artery disease (NOCAD). This study retrospectively tested the incidence of re-catheterization, and long-term outcomes of this population in patients aged over 50 years. (2)
: We identified all patients above 50 years of age with NOCAD who underwent their first CAG at our center between January 2008 and December 2019. Patients were evaluated for their baseline characteristics, risk factors profile, and indication for CAG. Patients undergoing repeat CAG after the index procedure were assessed for the above, including the primary preventive pharmacotherapy prescribed. (3)
: A total of 1939 patients were reported to have NOCAD. Of these, 1756 (90%) patients (62% males, median age 66 (56-75) years) had no repeat angiography (group 1). Repeat angiography was performed in 10%: 136 (7%) proved futile (median time for repeat angiography 5 (3-8) years) (group 3), and 47 (3%) ended with angioplasty (median time for repeat angiography 4 (3-6) years) (group 2). Male gender, BMI above 30 (23% vs. 13%), hypertension (68% vs. 57%), diabetes (28% vs. 17%) and smoking (36% vs. 19%) were significantly higher in the interventional group. Regression analysis showed both paroxysmal atrial fibrillation and hyperlipidemia were significantly associated with repeat CAG. The indication for the first CAG was mainly symptoms related. In the interventional repeat angiography (
= 47) the incidence of troponin positive cases increased from 8.2% before intervention to 57.5%, 50% being ST elevation cases. The symptoms-related cases went from 36.7% to 18.4%. Intriguingly, 85% of the interventional group were not prescribed statin and/or aspirin on a regular basis, and/or did not adhere to treatment. (4)
: NOCAD is a frequent occurrence. The threshold for repeat angiography must be higher, better reserved to troponin positive cases. Moreover, patients must be handled according to their risk profile, not being mistakenly reassured by a snapshot benign coronary angiography.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13030870</identifier><identifier>PMID: 38337564</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Angina pectoris ; Angiography ; Atherosclerosis ; Cardiac arrhythmia ; Cardiovascular disease ; Care and treatment ; Coronary heart disease ; Coronary vessels ; Diabetes ; Diagnosis ; Evaluation ; Heart ; Hyperlipidemia ; Hypertension ; Intubation ; Ischemia ; Medical imaging ; Medical prognosis ; Mortality ; Pain ; Patients ; Regression analysis ; Statistical analysis ; Vein & artery diseases</subject><ispartof>Journal of clinical medicine, 2024-02, Vol.13 (3), p.870</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c379t-aee259053c734acdc776df0cf6716e33fefe553bdf8733ae5ab36789cfb7aff53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38337564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roguin, Ariel</creatorcontrib><creatorcontrib>Kobo, Ofer</creatorcontrib><creatorcontrib>Meisel, Simha-Ron</creatorcontrib><creatorcontrib>Darawsha, Ziad</creatorcontrib><creatorcontrib>Odeh, Mahmood</creatorcontrib><creatorcontrib>Frimerman, Aharon</creatorcontrib><creatorcontrib>Amsalem, Naama</creatorcontrib><creatorcontrib>Abu Fanne, Rami</creatorcontrib><title>Repeat Coronary Angiography in Patients Aged over 50 Years with Previously Normal/Non-Obstructive Coronary Angiogram-Insights from a Retrospective Study</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>(1)
: A significant proportion of patients undergoing coronary angiography (CAG) have normal (NCA) or non-obstructive coronary artery disease (NOCAD). This study retrospectively tested the incidence of re-catheterization, and long-term outcomes of this population in patients aged over 50 years. (2)
: We identified all patients above 50 years of age with NOCAD who underwent their first CAG at our center between January 2008 and December 2019. Patients were evaluated for their baseline characteristics, risk factors profile, and indication for CAG. Patients undergoing repeat CAG after the index procedure were assessed for the above, including the primary preventive pharmacotherapy prescribed. (3)
: A total of 1939 patients were reported to have NOCAD. Of these, 1756 (90%) patients (62% males, median age 66 (56-75) years) had no repeat angiography (group 1). Repeat angiography was performed in 10%: 136 (7%) proved futile (median time for repeat angiography 5 (3-8) years) (group 3), and 47 (3%) ended with angioplasty (median time for repeat angiography 4 (3-6) years) (group 2). Male gender, BMI above 30 (23% vs. 13%), hypertension (68% vs. 57%), diabetes (28% vs. 17%) and smoking (36% vs. 19%) were significantly higher in the interventional group. Regression analysis showed both paroxysmal atrial fibrillation and hyperlipidemia were significantly associated with repeat CAG. The indication for the first CAG was mainly symptoms related. In the interventional repeat angiography (
= 47) the incidence of troponin positive cases increased from 8.2% before intervention to 57.5%, 50% being ST elevation cases. The symptoms-related cases went from 36.7% to 18.4%. Intriguingly, 85% of the interventional group were not prescribed statin and/or aspirin on a regular basis, and/or did not adhere to treatment. (4)
: NOCAD is a frequent occurrence. The threshold for repeat angiography must be higher, better reserved to troponin positive cases. Moreover, patients must be handled according to their risk profile, not being mistakenly reassured by a snapshot benign coronary angiography.</description><subject>Age</subject><subject>Angina pectoris</subject><subject>Angiography</subject><subject>Atherosclerosis</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Evaluation</subject><subject>Heart</subject><subject>Hyperlipidemia</subject><subject>Hypertension</subject><subject>Intubation</subject><subject>Ischemia</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Pain</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Statistical analysis</subject><subject>Vein & artery diseases</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkk1v1DAQhiMEolXpiTuyxAUJpXUy69g5rlYFKlVtVeDAKXKccdarxA62s2j_SX9uvdoC5cNzsDV63lfjmcmy1wU9A6jp-UaNBVCggtNn2XFJOc8pCHj-5H2UnYawoekIsSgL_jI7SlngrFocZ_d3OKGMZOW8s9LvyNL2xvVeTusdMZbcymjQxkCWPXbEbdETRsk3lD6QHyauya3HrXFzGHbk2vlRDufXzuY3bYh-VtFs8V_rMb-0wfTr5Kq9G4kkdxi9CxMeBJ_j3O1eZS-0HAKePt4n2dcPF19Wn_Krm4-Xq-VVroDXMZeIJaspA8VhIVWnOK86TZWueFEhgEaNjEHbacEBJDLZQsVFrXTLpdYMTrJ3B9_Ju-8zhtiMJigcBmkxfasp65JRWFSiSOjbv9CNm71N1e0pqBmtRfWb6uWAjbHaRS_V3rRZclHSuigFTdTZf6gUHY5GOYvapPwfgvcHgUqdCh51M3kzprY2BW32q9A8WYVEv3ksdW5H7H6xPwcPD2-3r6w</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Roguin, Ariel</creator><creator>Kobo, Ofer</creator><creator>Meisel, Simha-Ron</creator><creator>Darawsha, Ziad</creator><creator>Odeh, Mahmood</creator><creator>Frimerman, Aharon</creator><creator>Amsalem, Naama</creator><creator>Abu Fanne, Rami</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20240201</creationdate><title>Repeat Coronary Angiography in Patients Aged over 50 Years with Previously Normal/Non-Obstructive Coronary Angiogram-Insights from a Retrospective Study</title><author>Roguin, Ariel ; Kobo, Ofer ; Meisel, Simha-Ron ; Darawsha, Ziad ; Odeh, Mahmood ; Frimerman, Aharon ; Amsalem, Naama ; Abu Fanne, Rami</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-aee259053c734acdc776df0cf6716e33fefe553bdf8733ae5ab36789cfb7aff53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age</topic><topic>Angina pectoris</topic><topic>Angiography</topic><topic>Atherosclerosis</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Care and treatment</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>Diagnosis</topic><topic>Evaluation</topic><topic>Heart</topic><topic>Hyperlipidemia</topic><topic>Hypertension</topic><topic>Intubation</topic><topic>Ischemia</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Pain</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Statistical analysis</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roguin, Ariel</creatorcontrib><creatorcontrib>Kobo, Ofer</creatorcontrib><creatorcontrib>Meisel, Simha-Ron</creatorcontrib><creatorcontrib>Darawsha, Ziad</creatorcontrib><creatorcontrib>Odeh, Mahmood</creatorcontrib><creatorcontrib>Frimerman, Aharon</creatorcontrib><creatorcontrib>Amsalem, Naama</creatorcontrib><creatorcontrib>Abu Fanne, Rami</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roguin, Ariel</au><au>Kobo, Ofer</au><au>Meisel, Simha-Ron</au><au>Darawsha, Ziad</au><au>Odeh, Mahmood</au><au>Frimerman, Aharon</au><au>Amsalem, Naama</au><au>Abu Fanne, Rami</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Repeat Coronary Angiography in Patients Aged over 50 Years with Previously Normal/Non-Obstructive Coronary Angiogram-Insights from a Retrospective Study</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>13</volume><issue>3</issue><spage>870</spage><pages>870-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>(1)
: A significant proportion of patients undergoing coronary angiography (CAG) have normal (NCA) or non-obstructive coronary artery disease (NOCAD). This study retrospectively tested the incidence of re-catheterization, and long-term outcomes of this population in patients aged over 50 years. (2)
: We identified all patients above 50 years of age with NOCAD who underwent their first CAG at our center between January 2008 and December 2019. Patients were evaluated for their baseline characteristics, risk factors profile, and indication for CAG. Patients undergoing repeat CAG after the index procedure were assessed for the above, including the primary preventive pharmacotherapy prescribed. (3)
: A total of 1939 patients were reported to have NOCAD. Of these, 1756 (90%) patients (62% males, median age 66 (56-75) years) had no repeat angiography (group 1). Repeat angiography was performed in 10%: 136 (7%) proved futile (median time for repeat angiography 5 (3-8) years) (group 3), and 47 (3%) ended with angioplasty (median time for repeat angiography 4 (3-6) years) (group 2). Male gender, BMI above 30 (23% vs. 13%), hypertension (68% vs. 57%), diabetes (28% vs. 17%) and smoking (36% vs. 19%) were significantly higher in the interventional group. Regression analysis showed both paroxysmal atrial fibrillation and hyperlipidemia were significantly associated with repeat CAG. The indication for the first CAG was mainly symptoms related. In the interventional repeat angiography (
= 47) the incidence of troponin positive cases increased from 8.2% before intervention to 57.5%, 50% being ST elevation cases. The symptoms-related cases went from 36.7% to 18.4%. Intriguingly, 85% of the interventional group were not prescribed statin and/or aspirin on a regular basis, and/or did not adhere to treatment. (4)
: NOCAD is a frequent occurrence. The threshold for repeat angiography must be higher, better reserved to troponin positive cases. Moreover, patients must be handled according to their risk profile, not being mistakenly reassured by a snapshot benign coronary angiography.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38337564</pmid><doi>10.3390/jcm13030870</doi><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Age Angina pectoris Angiography Atherosclerosis Cardiac arrhythmia Cardiovascular disease Care and treatment Coronary heart disease Coronary vessels Diabetes Diagnosis Evaluation Heart Hyperlipidemia Hypertension Intubation Ischemia Medical imaging Medical prognosis Mortality Pain Patients Regression analysis Statistical analysis Vein & artery diseases |
| title | Repeat Coronary Angiography in Patients Aged over 50 Years with Previously Normal/Non-Obstructive Coronary Angiogram-Insights from a Retrospective Study |
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